Introduction Idiopathic Pulmonary Fibrosis (IPF) is a debilitating lung disease with average life expectancy of 3–5 years. IPF services in England, commissioned by NHS England, occur in a finite number of designated specialist centres. With the advent of antifibrotics early referral is paramount to impact disease pathogenesis. Inequalities in UK healthcare have been documented in lung disease. Our objective was to assess whether we received the expected number of referrals compared to the NICE predicted disease prevalence (0.0277%).¹

Methods This is a single centre review of University Hospital of South Manchester (UHSM) British Thoracic Society (BTS) entries from 2013 to 2017. Patient’s entry postcodes were mapped to individual clinical commissioning groups (CCG). IPF patients within each CCG were compared to the expected disease prevalence (0.0277%).

Results UHSM is the largest contributor to the BTS-IPF registry with 457 of the total 1119 patient record (41%). 451 patients from 35 English CCGs were represented. 6 patients were from outside England (Wales and Isle of Man). There are two specialist centres in the North West, Aintree and UHSM. 13 CCGs are located geographically closest to Aintree and 14 closest to UHSM with a further 8 CCGs located equidistant. Patients are referred to either specialist service at the discretion of the clinician and patient preference. The expected number of patients seen at UHSM according to IPF prevalence varied greatly in the 14 CCGs geographically closest with an average of 19 referrals per CCG (range 3–37) compared to the expected 51 referrals. CCGs varied in their referral rates with the top three CCGs Trafford (71%), Tameside and Glossop (65%) and Salford (54%) and the lowest referrals from Central (6%) and North Manchester (19%) (Table 1).

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Abstract P148 Table 1

CCGs geographically situated next to UHSM. Data demonstrates patients expected according to disease prevalance, actual number of referred and their according percentages

Conclusions Equality of access to specialist treatments for IPF remains a challenge. There is wide variation in the number of referrals to our specialist centre per patient population. The reasons for this disparity could be lack of detection of IPF, physician or patient factors. This presents a continued challenge for IPF management.

Reference

1. Navaratnam, et al. The rising incidence of idiopathic pulmonary fibrosis in the UK. Thorax2011;66:462–7.